Modified Four-Point Scleral Fixated Sutured Posterior Chamber Intraocular Lens Implantation Using 2 Eyelets...

Area of Science:

• Ophthalmology
• Surgical Techniques
• Intraocular Lens Implantation

Background:

• Posterior chamber intraocular lens (IOL) placement can be challenging in certain cases.
• Scleral fixation techniques offer an alternative for IOL fixation when capsular support is insufficient.
• Existing scleral fixation methods have varying degrees of complexity and material requirements.

Purpose of the Study:

• To present a modified 4-point scleral fixation technique for posterior chamber IOL placement.
• To evaluate the efficacy and safety of using a 2-eyelet polymethyl methacrylate (PMMA) IOL with 8-0 polypropylene sutures.
• To highlight the practical advantages of this modified technique.

Main Methods:

• A 270-degree conjunctival peritomy and four sclerotomies (nasal and temporal) were created.
• A lamellar scleral or clear corneal incision was made for IOL insertion.
• 8-0 polypropylene sutures were passed through the IOL eyelets and externalized through sclerotomies, followed by knot internalization.

Main Results:

• The technique was performed in 6 patients, achieving excellent visual outcomes.
• No complications were reported over a 1-year follow-up period.
• The technique offers advantages such as a stable PMMA IOL, a high-tensile, slim, and easily internalized 8-0 polypropylene suture, and affordable consumables.

Conclusions:

• The modified 4-point scleral fixation technique provides a viable option for posterior chamber IOL placement.
• This method offers practical benefits including cost-effectiveness and material availability compared to previous techniques.
• The procedure demonstrates moderate technical complexity with good clinical outcomes.